Combined effects of mild cognitive impairment and slow gait on risk of dementia
Combined effects of mild cognitive impairment and slow gait on risk of dementia
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DOI：
10.1016/j.exger.2018.06.002
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发表时间：
2018-09-01
影响因子：
3.9
通讯作者：
Shimoda, Hiroyuki
中科院分区：
文献类型：
--
作者：
Doi, Takehiko;Makizako, Hyuma;Shimoda, Hiroyuki
背景：轻度认知障碍（MCI）是转化为痴呆的高风险，步态功能障碍也是痴呆的风险。该研究的目的是检查 MCI 和慢步态 (SG) 同时发生是否会增加患痴呆症的风险。方法：对 3937 名基线时未患痴呆症的老年人进行了一项前瞻性研究。根据 MCI 和 SG 的状态将参与者分为几组：无 MCI 和 SG（对照）、无 MCI 和 SG（SG）、无 SG 且在单域（sMCI）或多域（mMCI）中具有 MCI、sMCI 和 SG（sMCI + SG）以及 mMCI 和 SG（mMCI + SG）。每月对痴呆事件进行追踪。使用 Cox 比例风险回归模型计算每组中发生痴呆的风险比。结果：在平均 43 个月的随访期内，182 名受试者发生了痴呆。 MCI 是痴呆症的危险因素，即使在调整协变量后，SG 也会增加风险（SG：HR = 1.31 (0.81-2.14)，95% CI = 0.276，sMCI：HR = 1.87，95% CI = 1.21-2.88，p = .005；mMCI：HR = 3.36，95% CI = 1.98-5.71，p < .001；sMCI + SG：HR = 3.33，95% CI = 1.92-5.77，p < .001；mMCI + SG：HR = 5.02，95% CI = 2.75-9.14，p < .001）。与单独每种情况相比，痴呆症的风险较高。步态和认知的评估对于痴呆症的风险评估很有用。
Background: Mild cognitive impairment (MCI) is a high risk of conversion to dementia and gait dysfunction is also a risk for dementia. The goal of the study was to examine if co-occurrence of MCI and slow gait (SG) increases the risk of dementia.Methods: A prospective study was conducted in 3937 older adults who did not have dementia at baseline. Participants were classified into groups based on status of MCI and SG: without MCI and SG (control), without MCI and with SG (SG), without SG and with MCI in a single domain (sMCI) or multiple domains (mMCI), sMCI and SG (sMCI + SG), and mMCI and SG (mMCI + SG). Incident dementia was followed monthly. Cox proportional hazards regression models were used to calculate the hazard ratio for incident dementia in each group.Results: During a mean follow-up period of 43 months, 182 subjects had incident dementia. MCI was a risk factor for dementia and SG increased the risk, even after adjusting for covariates (SG: HR = 1.31 (0.81-2.14), 95% CI = 0.276, sMCI: HR = 1.87, 95% CI = 1.21-2.88, p = .005; mMCI: HR = 3.36, 95% CI = 1.98-5.71, p < .001; sMCI + SG: HR = 3.33, 95% CI = 1.92-5.77, p < .001; mMCI + SG: HR = 5.02, 95% CI = 2.75-9.14, p < .001).Conclusions: Co-occurrence of MCI and SG has a high risk of dementia compared to that of each condition alone. Evaluation of both gait and cognition is useful in risk assessment of dementia.